摘要
【目的】探讨眼挫伤早期继发性青光眼患者药物治疗后血-房水屏障(BAB)功能的动态变化及其与眼压的关系。【方法】收集受伤时间在7 d内的闭合性眼挫伤患者61例61眼,分为高眼压组(39例39眼)和正常眼压组(22例22眼)。所有患者均予糖皮质激素和非甾体类药物治疗,眼压升高者予降眼压药物治疗。在治疗后不同时间点行激光蛋白细胞检测仪检测,对比高眼压组和正常眼压组不同时间点房水闪辉值与细胞数,分析房水闪辉值、细胞数与眼压的相关关系。【结果】挫伤患者眼压与房水闪辉值和房水细胞数呈正相关,相关系数分别为r=0.529和0.590(P<0.001)。高眼压组初诊时房水闪辉(pc/ms)、每0.5 mm3房水细胞数,均显著高于正常眼压组(78±60 vs 20±16,205±88 vs 50±16,P<0.001)。高眼压组初诊时眼压为(39±10)mmHg,治疗后末次眼压为(19±11)mmHg,较治疗前显著下降(P<0.001);眼压恢复至正常范围者31例(79.5%),仍高于21 mmHg者8例(20.5%)。两组患者LFCM值随治疗时间延长呈下降趋势;正常眼压组治疗后约30 d房水闪辉值(5±2)pc/ms和0.5 mm3细胞数(1±1)恢复至正常范围;而高眼压组治疗后120 d房水闪辉值(9±1)pc/ms和0.5 mm3细胞数(5±3)仍高于正常人(P<0.001)。【结论】眼挫伤早期继发青光眼患者的血-房水屏障功能的损害较正常眼压者严重,且与损伤早期眼压升高密切相关。抗青光眼药物治疗眼压控制的有效率为79.5%。合理应用糖皮质激素和非甾体抗炎药可以促进BAB功能恢复。
[Objective] To observe the recovery of BAB function in patients suffering from secondary glaucoma in early stage ocular contusion and the efficacy of medication therapy. [Methods] Sixty-one patients of ocular contusion in early stage were enrolled, and 30 healthy persons were collected as the control. Patients were divided into normal intraocular pressure group （NIOP） and high intraoeular group （HIOP）. Treatments included cortical steroids and/or NASIDs treatments in all patients and antiglaumatous medications in HIOP group. LFCM was tested in the first week and on day 14, 30, 60, 90, and 120 after ocular trauma. The correlation of lOP with flare level and ceils number in aqueous humor was analyzed. [Results] The results of flare values and cell counts were positively correlated with the IOP of all patients （r = 0.529 and 0.590 respectively, P 〈 0.001 ）. Before the treatment, both the flare level reading and the cells number reading in HIOP group [ （78 ±60）pc/ms, （205 ± 88） cells/0.5 mm3] were significantly higher than those in NIOP group [ （20 ± 16） pc/ms, （50 ±16） cells/0.5 mm3]. Flare level and cells number of all patients decreased gradually. In NIOP group, the LFCM readings [（5 ± 2） pc/ms, （1 ± 1） cells/0.5 mm3] were back to normal in 30 days while the readings in HIOP group [ （9 ± 1 ） pc/ms, （5 ± 3） cells/0.5 mm3] were still a little higher in 120 days. Pre- treatment and post- treatment lOP of H IOP group were （39 ± 10） mmHg and （19 ± 11 ）mmHg, and the lOP level was significantly lowered （P = 0.001 ）. Thirty-one patients in HIOP group （79.5%） had lOP controlled without further operations. [Conclusions] LFCM readings increase after ocular contusion especially in HIOP patients, and IOP is positively correlative with BAB impairment. The curative rate of medication for traumatic glaucoma in early stage could be 79.5%. Administration of cortical steroid and NSAIDs is effective in enhancing BAB recovery and is helpful to control the IOP.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2012年第4期512-516,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省医学科学技术研究基金(B2009083)
中山大学眼科学国家重点实验室专项经费
关键词
眼挫伤
继发性青光眼
血-房水屏障
药物治疗
ocular contusion
secondary glaucoma
blood-aqueous barrier
medical therapy
